Relação do grau de cifose torácica com os níveis de densidade mineral óssea em mulheres idosas / Relationship of the thoracic kyphosis degree with the levels bone mineral density older women / Relación del grado de cifosis torácica con los niveles de densidad mineral ósea en mujeres mayores

O objetivo deste trabalho foi mensurar o grau de cifose torácica em mulheres idosas, por meio do Método Flexicurva, correlacionando este achado com o de Densitometria Óssea (DMX), hábitos de vida e características antropométricas. Foram selecionadas 100 mulheres que haviam realizado o exame de DMX e divididas em 3 grupos de acordo com o nível de densidade mineral óssea (DMO): normal, osteogênicas e osteoporóticas. Realizou-se avaliação do grau de cifose torácica com o método Flexicurva. As variáveis: grau de cifose; DMO; idade; dados antropométricos foram comparadas entre os grupos e comparadas com os hábitos de vida. O grupo com osteoporose mostrou diferenças significativas quanto à idade, peso e IMC. Não foi observada diferença significativa nas variáveis relacionadas aos hábitos de vida. As participantes com osteoporose apresentaram maior grau de cifose torácica na postura habitual, porém sem diferença significativa entre os grupos. Também não houve correlação entre as variáveis analisadas. O envelhecimento, a diminuição do peso corporal e do IMC estão ligados ao processo de osteoporose. Flexicurva não foi capaz de diferenciar as idosas quanto ao nível de DMO.

The objective of this study was to mesure the kyphosis thoracic degree in older women through Flexicurve method, correlating this finding with Bone Densitometry, habits of life and anthropometric characteristics. 100 women who had undergone the examination of DMX were selected and divided into 3 groups according to the level of bone mineral density (BMD): the normal, osteopenic and osteoporotic. Was carried out assessing the degree of thoracic kyphosis with Flexicurve method. Variables: degree of kyphosis; BMD; age; and anthropometric data were compared between groups and compared with the habits of life. The group with osteoporosis showed significant differences in age, weight and BMI. No significant difference was observed related to lifestyle variables. The participants with osteoporosis showed higher degree of thoracic kyphosis in normal stance, but with no significant difference between groups. There was also no correlation between the variables. Aging, decreasing body weight and BMI are connected to the osteoporosis process. Flexicurve was not able to differentiate the older in the level of BMD.

El objetivo de este trabajo fue medir el grado de cifosis torácica en mujeres mayores, por medio del Método Flexicurva, correlacionando este hallazgo con el de Densitometría Ósea (DMX), hábitos de vida y características antropométricas. Se seleccionaron 100 mujeres que habían realizado el examen de DMX y se dividieron en 3 grupos de acuerdo con el nivel de densidad mineral ósea (DMO): normal, osteogénicos y osteoporóticos. Se realizó una evaluación del grado de cifosis torácica con el método Flexicurva. Las variables: grado de cifosis; DMO; edad; y datos antropométricos fueron comparados entre los grupos y comparados con los hábitos de vida. El grupo con osteoporosis mostró diferencias significativas en cuanto a edad, peso e IMC. No se observó diferencia significativa en las variables relacionadas con los hábitos de vida. Las participantes con osteoporosis presentaron mayor grado de cifosis torácica en la postura habitual, pero sin diferencia significativa entre los grupos. También no hubo correlación entre las variables analizadas. El envejecimiento, la disminución del peso corporal y del IMC están vinculados al proceso de osteoporosis. Flexicurva no fue capaz de diferenciar a las personas mayores en cuanto al nivel de DMO.

Baja masa ósea y osteoporosis en pacientes con lupus eritematoso sistémico / Low bone mass and osteoporosis in patients with systemic lupus erythematosus

RESUMEN Introducción: El lupus eritematoso sistémico es una enfermedad autoinmune, multisistémica y crónica, de etiología desconocida, en la cual la frecuencia de alteraciones en la densidad mineral ósea varía entre 25-74%; si bien su diagnóstico no está estandarizado. Objetivo: Describir las alteraciones densitométricas en pacientes con lupus eritematoso sistémico, así como las características clínicas y demográficas en 2 centros de referencia del noroccidente colombiano. Materiales y métodos: Estudio transversal realizado entre enero de 2013 y diciembre de 2014. Variables incluidas: demográficas, estado de menopausia, consumo de tabaco y alcohol, autoanticuerpos, compromiso orgánico, medicamentos e índices de actividad y cronicidad (SLEDAI, SLICC). Alteraciones densitométricas definidas según la Organización Mundial de la Salud. Análisis estadístico: Frecuencias absolutas y relativas para variables cualitativas; mediana con rango intercuartílico (RIQ) para variables cuantitativas. Resultados: De 302 pacientes evaluados, 65 cumplieron criterios de elegibilidad. Treinta y uno por ciento de las pacientes premenopáusicas tenían baja masa ósea para la edad; un 50% de las mujeres posmenopáusicas tenían osteoporosis y un 27% baja masa ósea. Número de pacientes con alteraciones densitométricas según factores asociados: fracturas 4, consumo de alcohol 2, fumadores activos 3, anticuerpos anti-Ro 8, afección neurológica 7, falla renal crónica 4. Uso de prednisolona: 53,8%; mediana de dosis diaria: 10 mg (RIQ5-52). Medianas de SLEDAI y SLICC: 0 (RIQ= 0-4) y 0,5 (RIQ= 0-1,75), respectivamente. Conclusiones: Se encontraron pocas densitometrías óseas en pacientes con lupus; la frecuencia de las alteraciones minerales óseas fue independiente del estado de menopausia. La mediana de dosis de prednisolona fue alta, en sujetos en remisión y sin daño orgánico.

ABSTRACT Introduction: Systemic lupus erythematosus is a chronic, autoimmune, multisystem disease of unknown aetiology, and in which the frequency of alterations in bone mineral density varies between 25% and 74%, although its diagnosis is not standardised. Objective: To describe the densitometric changes in systemic lupus erythematosus patients, as well as the clinical and demographic characteristics from two reference centres northwestern Colombia. Materials and methods: A cross-sectional study was conducted between January 2013 and December 2014. The data collected included the demographic variables, menopausal status, use of tobacco and alcohol, autoantibodies, organ involvement, medications, as well as the activity and chronicity indices (SLEDAI, SLICC). Densitometric changes were defined according to World Health Organisation criteria. Statistical analyses: Absolute and relative frequencies were calculated for qualitative variables, and medians with interquartile range (IQR) for quantitative variables. Results: Of the total 302 patients evaluated, 65 met eligibility criteria. Thirty-one percent of premenopausal patients had low bone mass for age was observed in 31% of pre-menopausal women, with 50% of post-menopausal women showing osteoporosis, and 27% low bone mass. The number of patients with densitometric alterations according to associated factors was, fractures 4, alcohol consumption 2, active smokers 3, anti-Ro antibodies 8, neurological involvement 7, and chronic renal failure 4. Prednisone was used in 53.8%, with a median daily dose of 10mg (IQR5-52). The median SLEDAI and SLICC was 0 (IQR = 0-4) and 0.5 (IQR = 01.75), respectively. Conclusions: Few bone densitometry results were found in patients with systemic lupus erythematosus. The frequency of mineral bone disorders was independent of menopausal status. The median dose of prednisone was high in subjects in remission, and without organ damage.

Changes of Total Body Bone Mass and Bone Mineral Density in Patients with Hemiplegia / 中国康复理论与实践

@#Objective To investigate the changes of bone mineral density (BMD) and bone mass and the influencing factors in patients with hemiplegia.Methods The total BMD, bone mass, lean mass and fat mass of 366 patients (313 stroke cases and 53 TBI cases) with hemiplegia were tested by dual-energy X-ray absorptiometry, as well as the clinical features of all patients, were studied.Results The bone masses in the paretic side (upper limb, lower limb and trunk) decreased significantly compared with nonparetic side ( P<0.01); the differences of bone masses (%) in upper limb, lower limb and trunk between paretic and nonparetic side decreased with duration of disease or trauma ( P<0.01). The multivariable stepwise regression analyses showed that the total bone mass and total BMD were negatively correlated with age and duration of disease significantly (all P<0.01), and positively correlated with body mass index (BMI) significantly ( P<0.01), the total BMD was also positively correlated with lean mass ( P<0.01) and ADL level ( P<0.05).Conclusion The bone mass deceases in the paretic side significantly, and gets worse with the duration of disease. Age, duration of disease or trauma and BMI influence total BMD and bone mass; in addition, total BMD is correlated with total lean mass and ADL level.